Provider Demographics
NPI:1124204706
Name:FRANCINE AGNOLI
Entity Type:Organization
Organization Name:FRANCINE AGNOLI
Other - Org Name:SILVER ROSE DESIGNS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:AGNOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-627-9180
Mailing Address - Street 1:56 MARTHA'S ROAD
Mailing Address - Street 2:PO BOX 1687
Mailing Address - City:EDGARTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02539-1687
Mailing Address - Country:US
Mailing Address - Phone:508-627-9180
Mailing Address - Fax:
Practice Address - Street 1:56 MARTHA'S ROAD
Practice Address - Street 2:
Practice Address - City:EDGARTOWN
Practice Address - State:MA
Practice Address - Zip Code:02539-1687
Practice Address - Country:US
Practice Address - Phone:508-627-9180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1116180001Medicare NSC